ELF Score is associated with clinical outcomes and disease progression in patients with chronic liver disease
- Katharine M Irvine1,†,
- Leesa F Wockner2,†,
- Mihir Shanker1,
- Kevin J Fagan1,3,
- Leigh U Horsfall1,3,
- Linda M Fletcher3,
- Jacobus P J Ungerer4,
- Carel J Pretorius4,
- Gregory C Miller1,
- Andrew D Clouston1,
- Guy Lampe5 and
- Elizabeth E Powell1,3,*
DOI: 10.1111/liv.12896 This article is protected by copyright. All rights reserved.
Issue 
Liver InternationalAccepted Article (Accepted, unedited articles published online and citable. The final edited and typeset version of record will appear in future.)
Additional Information(Show All) Author InformationPublication History Author Information- 1Centre for Liver Disease Research, School of Medicine, The University of Queensland, Brisbane, Australia
- 2Statistics Unit, QIMR Berghofer Medical Research Institute, Brisbane, Australia
- 3Department of Gastroenterology and Hepatology, Princess Alexandra Hospital, Brisbane, Australia
- 4Department of Chemical Pathology, Pathology Queensland, Brisbane, Australia
- 5Pathology Queensland, Princess Alexandra Hospital, Brisbane, Australia
* Correspondence to:
Elizabeth Powell, Department of Gastroenterology and Hepatology, Princess Alexandra Hospital, Woolloongabba 4102, Queensland, Australia. [email protected], Telephone: +61-7-34438015 Fax: +61-7-34438015
- This article has been accepted for publication and undergone full peer review but has not been through the copyediting, typesetting, pagination and proofreading process, which may lead to differences between this version and the Version of Record. Please cite this article as doi: 10.1111/liv.12896
AbstractBackground and AimsCurrent tools for risk stratification of chronic liver disease subjects are limited. We aimed to determine whether the serum-based ELF (Enhanced Liver Fibrosis) test predicted liver-related clinical outcomes, or progression to advanced liver disease, and to compare the performance of ELF to liver biopsy and non-invasive algorithms.
Methods300 patients with ELF scores assayed at the time of liver biopsy were followed up (median 6.1 years) for liver-related clinical outcomes (n=16) and evidence of progression to advanced fibrosis (n=18), by review of medical records and clinical data.
ResultsFourteen of 73 (19.2%) patients with ELF score indicative of advanced fibrosis (≥9.8, the manufacturer's cut-off) had a liver-related clinical outcome, compared to only 2 of 227 (<1%) patients with ELF score <9.8. By contrast, the simple scores APRI and FIB-4 would only have predicted subsequent decompensation in 6 and 4 patients, respectively. A unit increase in ELF score was associated with a 2.53-fold increased risk of a liver-related event (adjusted for age and stage of fibrosis). In patients without advanced fibrosis on biopsy at recruitment, 61% (11/18) with an ELF score ≥9.8 showed evidence of progression to advanced fibrosis (after an average 6 years), whereas only 13.5% of those with an ELF score <9.8 (28/207) progressed (average 14 years). In these subjects, a unit increase in ELF score was associated with a 4.34-fold increased risk of progression. Conclusions
The ELF score is a valuable tool for risk stratification of patients with chronic liver disease.
This article is protected by copyright. All rights reserved.
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发表于 2015-6-26 13:37
